Dear Doctor. Thank you for the useful information you provide to help deal with HIV infection management. I started taking HIV meds last year (Atripla)-Feb 2012- blood test results came back undetectable after 6 months. However, my recent (Feb 2013) tests show that my CD4 count has increased (450), but worryingly, I've reversed to detectable (54 000). Since inception I have been very compliant in taking the meds and a multivitamin supplement.I I recently (Decemebr 2012) underwent a hysterectomy and also wonder if the results could be impacted by this? My doctor says I should not worry for now, and we should check the outcomes of the next round of tests. I would like to hear your opinion and also advise on what I could do to reverse the detectable viral state without changing from Atripla. Thank you.

It is unlikely that surgery alone would have resulted in an increase in viral load from undetectable to 54,000. If you are taking your medications as prescribed this really shouldn't have happened. Unless your virus, for whatever reason has become resistant to one or more of the HIV medications in Atripla. I would repeat the viral load sooner than your normal interval for testing, and if still elevated, a HIV resistance should be performed to determine if your virus is now resistant to one or more drugs and whether a treatment change is now indicated.